Online Authorizations Application - CareAffiliate Quick Start Guide

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2 This is a brief overview of HAP s online authorizations application, CareAffiliate. For more in-depth help, you can find training manuals and other helpful resources when you log in at hap.org and select Authorizations- CareAffiliate Help under Quick Links or the Help link in the CareAffiliate application. Key Points Assessments Default Provider Most authorization requests require an Assessment to be completed. Have the clinical information available while you are completing it. Do not copy from a document and paste it directly into the Assessment. Instead, copy into Notepad on your computer; then copy from Notepad into an Assessment field. To select a non-hap contracted provider (Default Provider) on the Service 1 page: Click on the magnifying glass icon to search by NPI or by name. If the provider or facility does not return, unselect the Contract Only checkbox and search again. If no records return, enter provider NPI AUTH (or, AUTH9*), or facility NPI FAC (or, FAC99*), search again and select the record. Click on the Notes link in the box area to the upper left. Enter the provider and/or facility s complete name, NPI or out of country code, address, phone, fax and specialty. Logout vs. X To exit CareAffiliate, click on LogOut. Do not select X. Navigating from screen to screen You can easily move back and forth between screens by clicking the appropriate section. Required fields Timing out Wrong member or Request Type All fields outlined in orange are required After 89 minutes of inactivity in CareAffiliate, you will receive a warning that your session will time out in 1 minute. You will lose any information that has not been submitted. Select OK to continue working. Note: The timeout period for the HAP provider portal is 30 minutes. While you can still work in CareAffiliate for 90 minutes, you could be timed out of other applications (e.g., member eligibility, claims) after 30 minutes of inactivity. Simply log in again. If you enter the wrong member or request type, you must start the authorization over. Select Home at the top of the page. June

3 Entering a New Request Online Authorizations Application - CareAffiliate Log in at hap.org. Select Authorizations from home page. Select Authorizations from CareAffiliate home page. Select New Authorization. General Information Page Member ID or Name: Enter the member s HAP ID number or name and then tab. To search for member, select the magnifying glass icon. Request Type: Click on the magnifying glass to search. Place your cursor in the Request Type Description field and the select the Search button. This will return all the Request Types. Choose the appropriate type. (Note: medication requests begin with Drug-). Event Classification: This field will default to the appropriate value for some Request Types. For other Request Types, it will be blank and outlined in orange. If blank, you can select from pre-service, preservice-urgent (only if medically urgent), or post-service ( retro ). Contact Name and Contact Phone: For medication requests: enter the name and phone number of the ordering physician. For non-medication requests: enter the name and phone number of the person entering the request. Requesting Provider/Facility: Always a provider from your site. If the Requesting Provider/Facility is also performing the service, click the checkbox Use for all Requested Services. Diagnosis Code: Enter the diagnosis code in the Code field and tab (4 diagnosis code fields are available). When you ve completed this screen, select Service 1 in the orange box on the upper left side of the page. June

4 Service 1 Page Service From: Enter a date if the field isn t already populated (if populated, adjust as necessary). Service To: Enter a date (make sure it covers the duration of the treatment up to 1 year). Provider/Facility: Enter the refer-to Provider/Facility. See page 1 for notes on Default Provider. You can also select the i icon for instructions. Procedure Information: Select Edit and a new screen opens up. Enter procedure code or search for it. Fill in the quantity field(s). Note medications need billable quantities. See medication example below. When finished, select Ok. If you have an additional service to create, select the Copy Service hyperlink in the orange Service 1 box. A Service 2 page will appear. Delete the procedure code by clicking into the box next to the code. Select Delete Procedure. Select Add Procedure. Enter procedure and quantity. Medication example for entering quantity (For illustration purposes: 200 mg per every 1 week for 2 weeks) Enter the billable quantity as follows: Refer to the Procedure field for the number of units. Quantity: Take the prescribed dose and divide it by the number of units. (200 divided by 100 = 2) per every: Duration and appropriate length of time from drop down. for: Duration and appropriate length of time from drop down. Total: auto populates. When you ve completed this screen, select Assessment in the orange box in the upper left side of the page. Note: if the Assessment link is missing, an Assessment isn t required. June

5 Assessment Page Select Launch Assessment. Note: Disregard the words Met/Not Met throughout the Assessment. Complete all required fields outlined in orange. Enter any relevant information into the white fields. When finished entering information, select Complete and you ll receive an Assessment Summary. Note: If you remain in the Assessment after selecting Complete, look for the required fields that you missed. Review the summary for accuracy and completeness. You can add or correct information in the Additional Notes box. Sample Assessment Assessment Summary If you are finished with the request, click Submit in the upper right corner to send the request to HAP. Submission A confirmation page will appear. Click Yes to submit A summary page will appear with the following information at the top: Member Name, Gender, Age, Reference # and the status. You can print this page be selecting the Print button located in the upper right corner. June

6 Checking the Status of Authorization Request Log in at hap.org. Select Authorizations from the home page. Select Authorizations from the CareAffiliate home page. You are now at the status screen. You can search for an authorization by one of the options below: Reference # Member ID or Name For any of the searches below, you must enter dates in either the Service Dates From and To or the Submission Dates From and To (note: you can only enter a 30 day span of time) Requesting Provider ID or Name Servicing Provider ID or Name Servicing Facility ID or Name After you enter information, select Search Existing Records June

7 To see additional details, select the chevron next to the Reference #. Select appropriate request. Select Service 1. Review Status Reason. June